Effectiveness and feasibility of virtual reality and gaming system use at home by older adults for enabling physical activity to improve health-related domains: a systematic review
Open accessAbstract
BACKGROUND: use of virtual reality and commercial gaming systems (VR/gaming) at home by older adults is receiving attention as a means of enabling physical activity. OBJECTIVE: to summarise evidence for the effectiveness and feasibility of VR/gaming system utilisation by older adults at home for enabling physical activity to improve impairments, activity limitations or participation. METHODS: a systematic review searching 12 electronic databases from 1 January 2000-10 July 2012 using key search terms. Two independent reviewers screened yield articles using pre-determined selection criteria, extracted data using customised forms and applied the Cochrane Collaboration Risk of Bias Tool and the Downs and Black Checklist to rate study quality. RESULTS: fourteen studies investigating the effects of VR/gaming system use by healthy older adults and people with neurological conditions on activity limitations, body functions and physical impairments and cognitive and emotional well-being met the selection criteria. Study quality ratings were low and, therefore, evidence was not strong enough to conclude that interventions were effective. Feasibility was inconsistently reported in studies. Where feasibility was discussed, strong retention (≥70%) and adherence (≥64%) was reported. Initial assistance to use the technologies, and the need for monitoring exertion, aggravation of musculoskeletal symptoms and falls risk were reported. CONCLUSIONS: existing evidence to support the feasibility and effectiveness VR/gaming systems use by older adults at home to enable physical activity to address impairments, activity limitations and participation is weak with a high risk of bias. The findings of this review may inform future, more rigorous research.
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Both reviews showed that most studies were case studies with no comparators and used a variety of outcome measures, limiting conclusions about feasibility for healthy ageing.
“Both reviews showed that most studies were case studies with no comparators, and used a variety of outcome measures, limiting conclusions about feasibility for healthy ageing.”
From User experience of mixed reality applications for healthy ageing: A systematic review (2023) · cites this paper as Miller et al., 2014
The Study characteristics section (p. 4) reports seven case studies among 14 studies, alongside studies with comparative designs; seven of 14 is half, not most. Data extraction and quality assessment (p. 3) reports heterogeneous outcomes, and the Discussion (p. 7) says the evidence is too weak for sound recommendations about home-based VR/gaming. This paper supports that conclusion for its own review, but cannot establish what both reviews found. (LLM, conf=0.83)
Experimental — accuracy not yet measuredUnwanted side-effects were rare, including cybersickness and physical pain or over-exertion after MR use, provided that guidance and monitoring were in place, especially in the initial phase of use.
“More encouraging was the finding that unwanted side-effects were rare, including cybersickness and physical pain or over-exertion after MR use, provided that guidance and monitoring were in place, especially in the initial phase of use (Miller et al., 2014;Thach et al., 2020).”
From User experience of mixed reality applications for healthy ageing: A systematic review (2023) · cites this paper as Miller et al., 2014
The Feasibility section (p. 6) reports musculoskeletal pain and says initial assistance and monitoring were needed for safety. But it does not report cybersickness or over-exertion, and the Quality assessment (p. 6) notes insufficient adverse-event reporting, so the claim that side-effects were rare is not established. The review concerns home-based VR/gaming, not MR use generally. (LLM, conf=0.87)
Experimental — accuracy not yet measuredMiller et al. (2014) showed a strong retention and adherence rate between 63% and 100%, based on six of 14 studies.
“The review did show, however, a strong retention and adherence rate (between 63% to 100%), based on six of 14 studies.”
From User experience of mixed reality applications for healthy ageing: A systematic review (2023) · cites this paper as Miller et al., 2014
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Experimental — accuracy not yet measuredAside from conventional VR systems, both Miller and Thach failed to address use of non-standard MR applications for healthy ageing, such as bespoke solutions.
“Unfortunately, aside from conventional VR systems, both Miller and Thach failed to address use of (non-standard) MR applications for healthy ageing, such as bespoke solutions.”
From User experience of mixed reality applications for healthy ageing: A systematic review (2023) · cites this paper as Miller et al., 2014
The ‘Utilisation of gaming and virtual reality technologies’ section (p. 5) says nearly all reviewed studies used commercially available gaming technologies, supporting the claim about the review’s predominant focus. But it also discusses virtual cueing spectacles developed by named laboratories, so Miller did not exclusively address conventional systems. That example concerned walking in people with Parkinson’s disease; the passage does not establish whether the review addressed bespoke mixed-reality applications for healthy ageing. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe central focus of available reviews has been the effectiveness of MR applications, primarily on physical well-being and health outcomes, quality of life, motivation and social functioning.
“Rather, the central focus of the available reviews has been effectiveness of these applications, primarily on physical well-being and health outcomes, quality of life, motivation and social functioning (Buyl et al., 2020;Dermody et al., 2020;Miller et al., 2014).”
From User experience of mixed reality applications for healthy ageing: A systematic review (2023) · cites this paper as Miller et al., 2014
Study characteristics (p. 5) says the reviewed VR/gaming studies focused mainly on physical functions and activities, with three examining well-being, loneliness or quality of life. The Discussion (p. 7) mentions motivating elements, but motivation was not a central effectiveness outcome in this review. The source also concerns home-based VR/gaming for physical activity, not MR applications generally. (LLM, conf=0.83)
Experimental — accuracy not yet measured
Feasibility outcomes were reported inconsistently in the reviewed studies.
“Feasibility outcomes were reported inconsistently (e.g., recruitment information, retention rate, adherence and acceptability outcomes).”
From User experience of mixed reality applications for healthy ageing: A systematic review (2023) · cites this paper as Miller et al., 2014
Aspects of user experience in older adults have been addressed in two recent reviews, one on the use of VR for life enrichment and the other on the feasibility of VR systems for physical activity.
“Aspects of user experience in older adults have been addressed in two recent reviews of the literature, one on the use of VR for life enrichment (Thach et al., 2020) and the other on the feasibility of VR systems for physical activity (Miller et al., 2014).”
From User experience of mixed reality applications for healthy ageing: A systematic review (2023) · cites this paper as Miller et al., 2014
Studies included in reviews of MR for physical health were of low-to-moderate quality.
“While MR technology shows promising benefits for physical health, studies included in these reviews were of low-to-moderate quality (Buyl et al., 2020;Dermody et al., 2020;Miller et al., 2014).”
From User experience of mixed reality applications for healthy ageing: A systematic review (2023) · cites this paper as Miller et al., 2014
Miller et al. (2014) showed that available studies up to 2012 provided little evidence on the feasibility of home-based VR systems to improve the physical health of older adults.
“The review of Miller et al. (2014) showed that available studies (up to 2,012) provided little evidence on the feasibility of home-based VR systems (mostly commercially available technologies such as Nintendo Wii games and motion capturing systems) to improve the physical health of older adults.”
From User experience of mixed reality applications for healthy ageing: A systematic review (2023) · cites this paper as Miller et al., 2014
Most studies in these reviews focused on improving physical outcomes, while the impact of MR on other non-physical outcomes was typically overlooked.
“These reviews also suggested that most studies have focused on improving physical outcomes, while the impact of MR on other non-physical outcomes was typically overlooked.”
From User experience of mixed reality applications for healthy ageing: A systematic review (2023) · cites this paper as Miller et al., 2014
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BackgroundInfluential
- Authors
- Miller, K. J., Adair, B. S., Pearce, A. J., Said, C. M., Ozanne, E., & Morris, M. M.
- Affiliations
- University of British Columbia (CA)
- The University of Melbourne (AU)
- Deakin University (AU)
- Corresponding author
- Miller, K. J.
- Venue
- Age and Ageing
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-12-17
- Volume
- 43
- Issue
- 2
- Pages
- 188-195
- ISSN
- 0002-0729 (ISSN-L)
- 1468-2834
- OpenAlex
- W2112128025
- Cited by
- 243
- References
- 26
- Citations by year
- 2026: 5 · 2025: 15 · 2024: 16 · 2023: 24 · 2022: 29 · 2021: 28 · 2020: 25 · 2019: 22 · 2018: 21 · 2017: 17 · 2016: 15 · 2015: 20 · 2014: 6
- FWCI
- 4.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Age and Ageing (publishedVersion)
- PubMed (publishedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- Deakin Research Online (Deakin University) (submittedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Topics
- Social Sciences › Demography › Technology Use by Older Adults
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Keywords
- virtual reality, older adults, home-based physical activity, physical activity interventions, feasibility, effectiveness, activity limitation, participation, neurological disorders, cognitive well-being, emotional well-being, fall risk, musculoskeletal symptoms, adherence
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Aging, Cognition, Emotions, Feasibility Studies, Health Status, Humans, Mental Health, Middle Aged, Motor Activity, User-Computer Interface, Geriatric Assessment, Video Games
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